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MAIN APPLICATION <br />b.) Program Budget Detail <br />What is the cost to deliver your project/program? List each project/program element in the table <br />below, including the cost of each element, the quantity and unit of measure, and the subtotal for <br />each element. Where necessary, allocate costs to the use of shared space, vehicles or equipment. <br />Example Program: Credit Counseling Class <br />Cost Elements <br />Cost {$) <br />Quantity /Unit of measure <br />Subtotal <br />Credit Counseling Teacher –in class <br />$25 <br />96 hours (8 hrs/mth x 12 months) <br />$2,400 <br />Credit Counseling Teacher —class prep <br />$25 <br />48 hours (4hrs/mth x 12 mths) <br />$1,200 <br />Credit Counselor— one -on -one <br />$20 <br />120 hours (10 hrs/mth x12 mths <br />$2,400 <br />Materials <br />$25 <br />120 course packets /credit reports <br />$3,000 <br />Referral <br />$15.29 <br />Total <br />$9,000 <br />Complete the table below for the project /program for which Vou are requesting <br />funds. Attach additional rows /pages, as needed. <br />Program: Domestic Violence Crisis Services (Projected '16 -'17) <br />Cost Elements <br />Cost $ *.; <br />Quantity/Unit of measure ! <br />Subtotal ,($) <br />Crisis Counseling <br />$15.29 <br />7600 (# clients yr. X 15 min. of <br />$116,204 <br />service) <br />Information (education, all non - crisis <br />$15.29 <br />7100 (# clients yr. X 15 min. of <br />$108,559 <br />informational contacts, and follow ups) <br />service) <br />Referral <br />$15.29 <br />677 (# clients yr. X 15 min. of <br />$10,351 <br />service) <br />Shelter referral & assistance /hotel <br />$15.29 <br />270 (# clients yr. X 15 min. of <br />$4,128 <br />placement <br />service) <br />Legal information <br />$15.29 <br />1270 (# clients yr. X 15 min. of <br />$19,418 <br />service) <br />DV Protective Order paperwork assistance <br />$15.29 <br />330 (# clients yr. X 15 min. of <br />$5,046 <br />service) <br />Advocacy (general & court) <br />$15.29 <br />22000 (# clients yr. X 15 min. of <br />$33,638 <br />service) <br />Interpretation <br />$15.29 <br />155 (# clients yr. X 15 min. of <br />$2,370 <br />service) <br />Financial assistance (transportation, <br />$15.29 <br />142 (# clients yr. X 15 min. of <br />$2,171 <br />grocery cards, gas cards, food /toiletries) <br />service) <br />Main Application 1/24/2016 2:59:42 PM Page 49 of 58 <br />